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Friday, November 21, 2014

Emails released through freedom-of-information requests reveal
that at least two members of the US Center for Disease Control's Oral Health
Division have private worries about fluoride's risks to kidney patients but
publicly deny any concern.

Artificial fluoridation began in 1945,
aimed at teeth, without considering how unnatural fluoride chemicals could
affect other body functions or population subsets, such as kidney
patients.

CDC says, “The safety and effectiveness
of fluoride at levels used in community water fluoridation has been thoroughly
documented…”

Cc’d is William Bailey, then acting
Director of CDC’s Oral Health Division, who responds: “End stage renal disease
may be another issue. Since the body excretes fluoride through the kidneys, it
is reasonable to assume that people with end stage [renal] disease may
experience a buildup of fluoride.”

Bailey also mislead the Fairbanks, Alaska,city council in 2008 claiming studies he listed
proved fluoridation’s safety and effectiveness when they didn't.

Now working with the PEW-funded Campaign for Dental Health, formed
to protect and promote fluoridation, Bailey told the Loveland (Colorado) Utility
Commission on November 19, 2014: “I believe that
fluoridation is a healthy practice...It is not associated with any negative
health effects,” according a Loveland
newspaper.

The NRC reports that the kidney-impaired retain more
fluoride and risk skeletal fluorosis (an arthritic-type bone disease), fractures
and severe enamel fluorosis, which may increase the risk of dental decay. More
specifically:

“Human kidneys… concentrate fluoride as much as 50-fold
from plasma to urine. Portions of the renal system may therefore be at higher
risk of fluoride toxicity than most soft tissues.” p.280

“Early water fluoridation studies did not carefully assess
changes in renal function.” p.280

“future studies should be directed toward determining
whether kidney stone formation is the most sensitive end point on which to base the MCLG
[EPA’s maximum contaminant level goal allowed in water].” p.281

“The effect of low doses of fluoride on kidney and liver
enzyme functions in humans needs to be carefully documented in communities exposed to
different concentrations of fluoride in drinking water.” p.303

Dementi writes, "In discussing the effects of fluoride upon the kidney, it seems
appropriate at this point to indicate that whereas the kidney fulfills the
important task of removing toxic substances, such as fluoride, from the system.
There is the consequent danger of fluoride intoxication in those individuals
with impaired renal function who ingest fluoride...It is evident that
fluoridated water poses an enhanced threat to those among the populace who have
impaired kidney function."

In 1990, the New York State Department of Health published
a study, “Fluoride: Benefits and Risks of Exposure,”alerting officials that fluoride can be harmful to
kidney patients, diabetics and those with fluoride hypersensitivity
even at “optimal” levels. More study was advised; but ignored. Without this
vital information, government bureaucrats continue to claim fluoridation is
safe.

The National Kidney Foundation’s (NKF) former
fluoridation position statement also carried surprising cautions. The NKF
advised monitoring children’s fluoride intake along with patients with
chronic kidney impairment, those with excessive fluoride intake, and those
with prolonged disease. But NKF now admits, “exposure from food and
beverages is difficult to monitor, since FDA food labels do not quantify
fluoride content.” The USDA lists fluoride content of common foods here.

The NKF’s April 15, 2008
statement goes further: “Individuals with CKD [Chronic Kidney Disease] should be
notified of the potential risk of fluoride exposure.”

“More than 20
million Americans have CKD, and most don’t even know it. More than 20 million
others are at increased risk for developing CKD,” NKF reports.

The
American Dental Association, in its Fluoridation Facts Booklet,reports
that “decreased fluoride removal may occur among persons with severely impaired
kidney function who may not be on kidney dialysis.”

According to Schiffi in the Journal Nephrology
Dialysis Transplantation, “a
fairly substantial body of research indicates that patients with chronic renal
insufficiency are at an increased risk of chronic fluoride
toxicity.”

Bansal, et al. in Nephrology Dialysis
Transplantation reports: “Individuals with kidney disease have
decreased ability to excrete fluoride in urine and are at risk of developing
fluorosis even at normal recommended limit of 0.7 to 1.2mg/l of fluoride in
drinking water.”

Ng, et al, report in the journal, Bone, their research
suggest that “in ROD [renal
osteodystrophy], bone
fluoride may diminish bone microhardness by interfering with
mineralization.”

Researchers report “that drinking water fluoride levels over 2.0 mg/L can
cause damage to liver and kidney functions in children and that the dental
fluorosis was independent of damage to the liver but not the kidney, published
in Environmental
Research.

According to a 1975 editorial in Kidney International,
“Trace doses of fluoride
leave the blood within minutes, concentrating principally In

Thursday, November 20, 2014

A CDC
fluoridation spokesperson, dentist William Bailey, told the Fairbanks, Alaska, City Council in 2008 that the CDC
doesn't do original fluoride/fluoridation safety research. Instead the CDC
relies on many reviews and reports from the US and other countries. Some of the studies
Bailey cited actually do not support fluoridation's safety and/or efficacy
as he professed: Transcript: https://web.archive.org/web/20080531015347/http://fluoridealert.org/bailey1.html

Legislators rely on government officials and rarely fact-check their testimony. But we did.

Here’s the truth about
reports Bailey served up (some still listed on the CDC's website under fluoridation safety):

National Research Council (2006)

This isn’t a fluoridation risk/benefit analysis. It found EPA’s current
fluoride maximum-contaminant-level-goal (MCLG) for drinking water is not
protective of health and must be lowered. EPA has yet to act upon this
recommendation. Several members of the NRC panel believe fluoride's MCLG should
be as close to zero as possible. (1)

Agency for
Toxic Substances and Disease Registry (2003)

This report says "… subsets of the population
may be unusually susceptible to the toxic effects of fluoride and its
compounds…the elderly, people with osteoporosis, people with deficiencies of
calcium, magnesium, vitamin C, and/or protein." (2)

University of York, UK (2000)

About this report, the Centre for Review and
Dissemination writes “We were unable to discover any reliable good-quality
evidence in the fluoridation literature world-wide.”(3)

Lewis and
Banting, Canada (1994)

“The effectiveness of water fluoridation alone
cannot now be determined,” they write.(4)

New York
State Department of Health (1990)

Researchers report thatfluoride can be
harmful to kidney patients, diabetics and those with fluoride hypersensitivity
even at “optimal” levels..

The authors concluded, “…it is currently impossible to draw firm
conclusions regarding the independent effect of fluoride in drinking water on
caries prevalence using an ecologic study design.”(5)

World Health
Organization (2006)

This report, not about fluoridation, documents high
levels of natural fluoride causing human bone and teeth malformation in many
countries.(6)Medical Research Council, UK (2002)

This report, not a fluoridation risk/benefit
analysis, identifies fluoridation health uncertainties such as total exposure
and bone effects.(7)

Institute of
Medicine (1999)

Since fluoride is not a nutrient, this report set
the adequate intake from all sources to avoid children’s moderate dental
fluorosis (discolored teeth) and, also, the upper limit to avoid crippling bone
damage -- which the IOM admits “is too high for persons with certain
illnesses…”(8)

References:

1) Fluoride in Drinking Water: A Scientific Review of
EPA's Standards," Committee on Fluoride in
Drinking Water, National Research Council, Executive Summary,
2006http://www.nap.edu/nap-cgi/report.cgi?record_id=11571&type=pdfxsum

Sunday, October 12, 2014

This letter was written in 2005, after I attended
an expensive PR event to promote fluoridation hosted by the Centers for Disease Control and the American Dental
Association atthe ADA's Chicago headquarters. I don’t remember if I received
a reply from now-retired dentist William Bailey who was the CDC’s
primary fluoridation promoter.

William Bailey, DDS,
MPHDepartment of Oral HealthCenters for Disease Control and
PreventionAtlanta, Georgia

Hi Bill

It was a pleasure speaking
with you at the fluoridation symposium even if you are on the wrong side of
the issue. It's so rare that I meet a fluoridation proponent who is as
courteous as you were to me. And I thank you for that. However, what I heard
at that symposium is disturbing.

A thread running through the
delivered speeches is that you all seem to believe that folks opposed to
fluoridation disseminate misinformation. No fluoridation opponents were
speaking before this assembled crowd. Yet lots of misinformation and
improper behavior was flowing, for example:

1) Dr. Lynn Mouden's
presentation about the Arkansas fluoridation battle maligned one of my new
friends, and Mouden's fellow Arkansasan, who was outside picketing. He also
insulted Arkansas legislators and falsely reported that State Senator Jack
Critcher voted down the fluoridation mandate bill. An Arkansas
newspaper, "The Lovely Citizen," reported Mouden's words and then
Critcher's correction of Mouden's un-truths (See:
http://www.fluoridealert.org/news/2352.html). I suggest this article be
disseminated to all Symposium attendees as a "what not to do" and hope they
don't repeat Mouden's misstatements and further malign or embarrass Arkansas
residents, legislators or themselves.

2) Several speakers dismissed Dr.
Dean Burk and Dr. John Yiamouyiannis' cancer study because it wasn't
adjusted for important variables, they said. This often-repeated criticism
is false. Burk/Yiamouyiannis did make adjustments. When fluoridation
proponents are put on the witness stand in courts of law, they are
unable to scientifically invalidate the Burk/Yiamouyiannis study.

For
example, Pennsylvania Judge Flaherty presided over a case which focused on
the validity of the Burk-Yiamouyiannis study. Over the course of five
months, the court held periodic hearings which consisted of extensive expert
testimony from as far away as England. Flaherty found "[p]oint by point,
every criticism made of the Burk-Yiamouyiannis study was met and explained
by the plaintiffs. Often, the point was turned around against defendants. In
short, this court was compellingly convinced of the evidence in favor of
plaintiffs [fluoridation opponents]."

Then fluoridationists further
misinformed legislators, others and me by reporting that Flaherty's case was
"thrown out of court for lack of evidence." So I wrote to Flaherty in 1996.
This is what he said: "My decision regarding the fluoridation of the public
water supply, made during my tenure as a trial judge almost twenty years
ago, was on appeal, purely a jurisdictional issue...That the practice is
deleterious is more and more accepted -- its utility doubted."

3)
Another speaker, Dr. George Stookey, reported that after 15 years of water
fluoridation which began in 1945, Grand Rapids had about a 50% less tooth
decay rate than Muskegon, the non-fluoridated control city. He stressed that
no other fluoride was around back then. However, Muskegon started
fluoridation in 1951. So, in effect, Stookey's comparison was made between
two fluoridated cities, which actually indicates something other than
fluoridation was protecting the teeth of Grand Rapids' children.

4)
I was shocked when Missouri's Ashley Micklethwaite expressed fear of
anti-fluoridationists in her talk. She advised attendees to get unlisted
phone numbers to avoid us. It seems fluoridationists have been so good at
creating a negative image of Americans who fight for pure water that they
believe their own PR.

When my and my daughter's picture appeared in a
Long Island newspaper in the early 1980's as opposed to fluoridation, I got
very alarming phone calls directed to my then 5-year-old. I never assumed
these troubling calls were from dentists or fluoridationists. However,
Dentists don't have a monopoly on sanity. Google searches reveal dentists
who murder, rape, commit Medicaid fraud and more. We don't judge a whole
barrel by a few bad apples. So I'm surprised your speaker expressed such a
fear of us.

If only you had allowed chemistry professor Paul Connet, PhD,
Executive Director of the Fluoride Action Network to speak as he and I
requested, Ms Micklethwaite would have seen her fear was misguided. Also,
maybe Dr. Connett could have corrected your speakers' blunders before they
permeate throughout the country and those 7 foreign countries which were
represented at the symposium.

Not there to defend himself, one of your
speakers took a cheap shot at Dr. Connett. Florida dentist Robert Crawford
said, "The fellow that was out here in the book covers when you went to the
celebration of fluoridation out in the tent the other day [Paul Connett]
. They flew him in to debate us. Can you imagine what you feel like standing
up here and debating somebody standing between two book covers." This
brought laughter from the audience who, apparently, are quite comfortable
denigrating opponents of fluoridation.

Crawford bragged about his
successful Pinellas County fluoridation strategy. He made this outrageous
statement, "We identified county officials who were anti-fluoride and we had
no further contact with them. And we cut them off, totally." In effect,
Crawford cut off anyone who doubted fluoridation; hardly a noble thing to
do. Is he protecting people or fluoridation? Would his malpractice insurance
cover him should he use the same tactics with a patient who questions
him? I found him quite disturbing.

5) A symposium attendee, during a
question and answer period, brought up misinformation disseminated on the
National Institutes of Dental Research's (NIDCR) website, where a "history
of fluoridation" said H. Trendley Dean did not find fluorosis at "optimal"
levels of fluoride in drinking water. This person called and spoke to the
writer at NIDCR who then researched his objection and agreed it should
be re-written. However, she said it was a low priority for her and she would
get around to it someday. Since the symposium and his public revelation of
this error, it has been corrected, however, but not before the incorrect
information from this "reliable source," the NIDCR, was repeated in On Tap
magazine and elsewhere.

I and others opposed to fluoridation are
routinely personally denigrated by dentists and/or fluoridation proponents
in person, in writing and on the internet, including from members of the
public-dental-health listserv (my taxes at work?). I was called a
baby-killer to my face by a dentist. Many exceedingly derogatory and ugly
comments have been and are directed towards me on the internet where
some dentists actually sign their real names and addresses, their
criticism so apparently accepted within the profession. Dentists opposed
to fluoridation are routinely tongue lashed by their colleagues on internet
mail lists and message boards.

I can only wonder what's been going on in
private fluoridation meetings and at taxpayer subsidized dental schools over
the years to provoke such hatred towards us.

This may be why
California Dentist David Nelson felt so comfortable laughing at us on
Wednesday July 13, 2005, while I snapped his picture. Nelson mockingly told
me he was Kip Duchon, a federal employee. This, by the way, is a federal
crime which I reported to his superiors, who probably will do nothing about
it.

I was also offended when Dr. Nelson and two female colleagues
chuckled when the Missouri presenter made a reference to San Jose woman
writing and sending information to Missouri legislators. I felt like I was
back in Junior High School. It scares me that these people are guardians of
my health.

Fluoridation proponents have created an American myth that
fluoride is absolutely safe. The average person is afraid to overdose on the
water-soluble, relatively harmless vitamin C. But very few Americans
similarly fear fluoride. That's very odd. Since just a teaspoon of
fluoride could and has killed. That may not be your intention; but
that's certainly the reality.

As you know, very few grants are
available to study ill health effects of fluoride. And studies declaring
fluoridation's benefits are out-dated and scientifically flawed by today's
standards, according to the National Institutes of Health and the UK's York
Commission.

I hope in the future you will invite Dr. Paul Connett,
Dr. William Hirzy, Dr. David Kennedy or another equally qualified
fluoridation opponent to speak before any fluoridation meeting, symposium or
gathering. You are doing no one a service by disallowing our
participation in tax-payer funded fluoridation programs.

If your goal
is to protect the health of Americans, you'll invite one of our speakers. If
your goal is just to win, you will not. If our science is so misrepresented
as fluoridationists tell legislators in private, you'll be able to show us
where we are wrong in public.

The internet is often maligned as
providing misinformation to fluoridation truth seekers. But the truth was
definitely not on display at this government sponsored event. I fear New
York State Department of Health employees, present at this symposium, will
come back armed with misinformation, and use it to fluoridate more New
Yorkers against their will and without their full knowledge of harm,
further wasting my taxes.

However, I did enjoy our pleasant
conversation about New York State. Someday I'd like to have a pleasant
conversation with you about fluoridation.

Wednesday, September 24, 2014

The following FOIA-obtained emails seems to show how the US Centers for Disease Control (CDC) works closely with the American Dental Association (ADA) and the PEW Foundation to protect fluoridation rather than the American public whose health they are entrusted to protect. The documents also reveal the disdain and lack of respect for people (me) who ask valid questions concerning fluoridation. I added the red parts to further identify the major
players.

Iregret to inform you that
Carol Kopf seems to have gotten my email and she sent this directly to me,the first such instance, but no
doubt, not the last. I am forwarding a copy of my response to you for you of
all people probably need to know she is digging deeper into this issue. I think she was very displeased to hear about the Belgium supplier that we only recently
identified a couple of months ago.

This was a combined investigative
effort of Dave Hellmann and me to identify them
and find out about their product They really have not been marketing in the US,
but the AWWA committee is working to get the word out for they produce
their product using the old Solvay method and looks like a very nice product.
I'm not too sure, but wouldn't it be great if it was
actually a byproduct of chocolate manufacturing, but it is unlikely.

Kip Duchon, P.E.

National Water
Fluoridation Engineer

----------------------------

From: Duchon, Kip (CDC/ONDIEH/NCCDPHP)

Sent: Wednesday, May 05, 2.010 11:06 AM

To: 'Carol
S. Kopf

Subject: RE: Chinese Fluoride

Dear Carol

Normally requests for information should come in through
our public information box so that the
correct person can answer the question you
might have. That can be found at http://www.cdc.gov/fluoridation/contact.htm

I am
probably the correct person for this particular question, so I will be glad to answer your question.

Since the EPA terminated their additives program in 1988, they simply do not have the
resources to track the over 50 additives used in water treatment facilities. NSF
International is a standards organization and does not track this type of information
but they do monitor the activities of the certifying entities and report to the
Association of State Drinking Water Administrators and EPA. Both NSF (a
different entity from NSF International) and UL, which combined represent over 85%
of the water fluoridation additive certification activities, do not publically report on tonnage or marketing.

CDC does not have an additives monitoring program but we compile some limited information on the topic, and
I will attempt to give you
my best opinion on these answers, but please understand this is my opinion and
not the opinion of

CDC since we don't actually have a formal additives program.

My understanding is that the Chinese sodium fluoride that is NSF Standard 60 certified is derived from a full neutralization of fluorosflicic acid using caustic soda, but I have not actually been to the production facilities to
confirm that information.

Sodium fluoride products with Standard 60 certification are
derived from either full neutralization of fluorosilicic acid, or neutralization
of hydrogen fluoride.

A majority of the sodium fluoride being used in
the US is derived from
fluorosilicic acid and an AWWA survey of water plant operatorsusing
sodium fluoride in saturators
that is currently being
compiled has preliminary results showing that a majority of operators are
satisfied with the fluorosilicic acid derived product, but there seems to be a preference for the hydrogen fluoride
derived product. These products are not by-products but are specifically made
for uses including water fluoridation.

At this time, product is available from China, Japan, and Belgium

and a US domestically produced product is certified from a facility in Illinois that is currently not producing
product but has periodically been used intermittently in the past few years.

The AWWA survey is part of our effort
to periodically review our standards and if there is change or difference in the products and if an update is
needed. That survey is in progress and results are not yet
complete.

Sodium fluorosilicate with Standard 60 certification is derived
from partial neutralization of fluorosilicic acid. It is not a byproduct butis specifically manufactured for use including water fluoridation.
At this time the overwhelming source is domestically US produced, but NSF
certified product is also available from China and Belgium

NSF Standard 60 certified Fluorosilicic is overwhelmingly
produced in the US as a high-purity vacuum extraction
from gypsum slurry derived from phosphate fertilizer production. There are no
smokestacks belching this stuff although that is

a great science fiction tale. Less than 5% of the product is
from gas partitioning of silica-tetrafluoride from hydrogen fluoride and less
than 1% is from hydrogen fluoride etching of silica products. The product is
available from US, Mexican,

and Canadian sources.

Kip Duchon, P.E.

National Water Fluoridation Engineer

----------------------------------

From: Carol S. Kopf

Sent: Wednesday, May 05, 20109:32AM

To: Duchon,
Kip (CDC/ONDIEH/NCCDPHP)

Subject: Chinese Fluoride

Kip

Both the EPA and NSF International haven’t been able to answer
this question for me. Hope you will.

It is about the Chinese fluoride. Is it derived from phosphate
fertilizer? If not, what is it derived from.

Also the CDC's website says that most of the fluoridation
chemicals are collected from fertilizer companies; but not all. What are the
other sources of fluoridation chemicals?

Are they made specifically for fluoridation or are they a
by-product of some other manufacturing process?

A Louisiana State Legislator said on the floor of the State
Senate yesterday that some fluoridation chemicals are purchased from Belgium? ls that true?

Please name all the countries that import fluoridation chemicals
into the US

Cc: Bailey, William (CDC/ONDIEH/NCCDPHP); Lewis Lampiris (lampirisl@ada.org) [In 2006, Lampris began working with the American Dental
Association as director of the Council on Access, Prevention and
Interprofessional Relations; he held this appointment until 2012.]

Subject: Implications of CDC demotion, as seen through eyes of CWF opponent

I don't want to overreact
to the rantlngs of a long time
anti-fluoridationist,but l.came across something that may get traction in contributing to perceptions about what HHS and CDC really believe about fluoridation now {sinceto save face, it is unlikely to retract its 1999 proclamations about fluoridation as a great public health achievement}.

Councilman Vallone, of NY City, has proposed discontinuation of CWF in NYC. Dr. Neal Herman, a former citydental director, wrote Vallone a letter, which Vallone's office has shared with many long-standing opponents of fluoridation, including Carol Kopf, who wrote the attached letter. [Apparently the NYC Dental Director shared my letter with Bill Maas. Why? You can read my whole letter here http://fluoridedangers.blogspot.com/p/blog-page.html ]As usual, it includes a difficult-to-separate mix of correctly quoted statements from credible scientific reports
along with misleading assertions about health risks or lack of
health benefits from fluoridation.

But, what caught my eye as new was the following:

"You mention that the Centers for Disease
Control recognizes fluoridation as one of theten greatest and effective public health
innovations ever. Then why has tooth decay
rates gone up since that statement was made and why was the CDC’s
oral health Division demoted to a branch no longer working for children. It seems that
statement just doesn't hold water. It's just words strung together that has no
scientific basis."

About the only good thing l can say about the reorganization is that the Division of Population Health is to include what used to be the Division of Adolescent and School Health, but I
don't know how visible that will be to counter the charge that this is a Division not "working for children".

This certainly is relevant to the
recommendations of the IoM committee to HHS that perceptions matter. CDC’s
reorganization sends a message about one of the gret public health achievements
of the 20th century that may be difficult to counter.

Bill Maas

----------------------

From: Bailey, William (CDC/ONDIEH/NCCDPHP)

Sent: Thursday,
May 05, 20111:34 PM

To: 'BMaas~consultant@
pewtrusts.org';
'shermanj@ ada.org'

Cc: 'lampirisl@ ada.org'

Re: Implications of CDC demotion, as seen
through eyes of CWF opponent

So true.

---------------

From: Bill Maas (Consultant) [mailto:BMaas-consultant@pewtrusts.org]

Sent: Thursday,
May 05,
201101:09 PM

To: 'Sherman, Judy C.'

Cc: Bailey, William (CDC/ONDIEH/NCCDPHP); Lampiris, Lewis N.

Subject: RE: Implications of CDC demotion, as seen through
eyes of CWF opponent

Yes, it reveals how carefully fluoridation's opponents watch organizational actions like that of CDC, and how readily they will use that to undermine public health.

----------------------------------

From: Sherman, Judy C. [mailto:shermanj@ada.orgl [ADA Lobbyest]

Sent: Thursday, May O5, 2011 1:07 PM

To: Bill Maas (Consultant)

·Cc: 'wdb9@cdc.gov'; [William Bailey]; Lampiris, Lewis N.

Subject: Re: Implications of CDC demotion, as seen
through eyes
of CWF
opponent

Thank you for this. May I share with people on the Hill?

---------------------------------------

These emails were part of 2600 pages of
documents obtained by Dan Stockin, MPH, and revealed at the 5th
Annual Fluoride Action Network conference on September 6-8 in Washington DC.

Monday, August 25, 2014

“Some fluoride-containing products, however, have enough of
the ion to be hazardous and should be handled and stored with caution.For example, a 1.23 percent fluoride gel contains
12,300 ppm or 12.3 milligrams per gram [such as dentists' fluoride treatments]. Thus, one ounce (28.3) grams) contains
348 milligrams, a life-threatening dose for a 11.5 kilogram or a 25 pound
child.Even the popular fluoride
toothpastes may be hazardous to small children. These products typically
contain 0.1 percent fluoride or 1000 ppm.Thus, an eight ounce tube containing 226 milligrams of fluoride, could endanger
a 16 or 17 pound child…Therefore such products should be kept out of the reach
of those who are at risk."

“Dental fluorosis, a disorder of enamel mineralization which
can be produced only during the development of the enamel prior to tooth
eruption, is generally regarded as a toxic manifestation of chronic intake of
excessive fluoride.Exactly, how much
fluoride is too much is uncertain.”

Gary M.
Whitford, PhD, DMD, August 1981

“Fluorides:
Mechanism of Action Efficacy and Safety,”

Dental Caries Prevention in Public Health
Programs

Proceedings of
a Conference October 27-28 1980

Sponsored By the National Caries Program

National Institute of Dental Research

US Department of Health and Human Services

Edited by
Alice M. Horowitz and Hilah B. Thomas

Excerpts above and below by Gary M. Whitford, PhD, DMD

Dr. Nichols asks Dr. Whitford the following question: "If I gave you two items, one a 9 ounce size of Crest toothpaste another a 7 ounce bottle of 0.2 percent sodium fluoride solution, could you discuss the toxicity of each in relation to a 20 kilogram child?"

Dr. Whitford answers "There would be 225 mg of fluoride in the tube. The 7 ounce bottle is about 0.1 percent fluoride so it would contain about 200 mg of fluoride...I think that the potential for toxicity, if ingested all at once, would be about equal. Assuming that 30 mg of fluoride per kilogram of body weight is fatal, these doses would be dangerous for seven and nine kilogram children, respectively [15 to 20 pounds]. I'm unaware of any report indicating that death has occurred from the ingestion of toothpaste or a 0.2 percent sodium fluoride solution. It is, however, conceivable that it could happen. For that reason, when our children were younger, we purchased the 4 to 6 ounce tube of toothpaste and kept them out of their reach."

Fluoride is readily absorbed from the gastrointestinal
tract. That which appears in the feces is mainly if not entirely, unabsorbed
fluoride and usually accounts for only about 5 to 10 percent of the amount
ingested daily. Some factors, however, decrease the absorption of fluoride,
particularly divalent and trivalent cations such as calcium, magnesium and
aluminum. If high concentrations of these ions are present with the fluoride at
the time of ingestion, systemic absorption is reduced.

From the plasma, fluoride diffuses to the extra cellular and
intracellular fluids of the soft tissues where it rapidly reaches a steady-state
distribution.

As the plasma curve rises, so do the concentrations of
fluoride in the muscle, the liver, the heart, and all soft tissues

The excretion pattern of fluoride, however, is not exactly
this way in all people.The age of the
individual influences how much fluoride is removed from the body...The excreted percentage of a fluoride dose
generally varies as a direct function of age. The younger the individual, the
less excretion.The older the
individual, the more of a given dose is excreted.This result is attributable principally to
the growth rate and age of the skeleton and the surface area of bone mineral
available for fluoride uptake. In the growing individual, these factors favor
enhanced fluoride uptake so that relatively less is excreted in the urine.

According the some findings that we made a few years ago,
fluoride excretion is a function of the pH of the urine. At a low pH, fluoride
excretion is also low and as the urine pH rises, the rate of fluoride excretion
rises as well.

The diet of most infants is either mother’s milk or a formula
based on cow’s milk.The urine pH of infants who are solely formula fed is
generally lower, sometimes markedly so, then that of solely breastfed infants
and the would be expected to excrete less of the fluoride delivered to the
kidneys in the blood.Such differences
in excretion rate might or might not be desirable depending on the quantities
of fluoride involved.

Thus, difference in diet, among several other important
factors, will tend to produce urine pH values that approach one end or the
other of the physiologic range. These factors influence the uptake of fluoride
by developing teeth and the fluoride levels of the oral fluids. Therefore, they
can affect the cariostatic efficacy of fluoride in certain individuals or
perhaps the development of fluorosis in others.

Dental fluorosis, a disorder of enamel mineralization which
can be produced only during the development of the enamel prior to tooth
eruption, is generally regarded as a toxic manifestation of chronic intake of
excessive fluoride.Exactly, how much
fluoride is too much is uncertain.”…Probably no single dose, or narrow range of
doses can be determined because of several variables. The age and body weight
of the child or fetus, the frequency of the doses, the peak plasma levels, the
magnitude of the more sustained fasting plasma level, are among the factors to
be considered.Nevertheless, the early
data provided by Dean are pertinent.

According to his findings and classification system, when
the community index of fluorosis exceeds 0.6, the incidence and severity of fluorosis
begins to constitute a public health problem warranting increasing
consideration.This index value was
reached in communities with water fluoride levels of 1.6 to 1.8 ppm.Thus the margin of safety for avoiding a
degree of dental fluorosis which may be of public health concern is rather low
at somewhat less than two and is another reason for carefully monitoring
fluoride levels in water.